​​​​Choosing Wisely Level 1 Hospital: Ross Memorial Hospital, Lindsay, ON (Photo Credit: Amanda Carvalho​)

Ontario hospitals face increasing pressures to address systems capacity while simultaneously treating patients with growing complex care needs. Recent data demonstrates that variation in hospital care across the province is substantial. Examples include the frequency of pre-operative ECG testing for low-risk surgeries ranging from 3.4%-88.8% among hospitals, and unnecessary CT scans for minor head trauma varying from 13% to 46% across different regions of the province.^1,2 Reducing unnecessary health care represents a significant opportunity to manage finite hospital resources and to deliver evidence-based, patient-centred care.

In January 2019, Choosing Wisely Canada collaborated with the OHA to support hospitals to take steps toward implementing Choosing Wisely Canada recommendations within their facilities. Hospitals that choose to do so are supported by a starter kit, webinar series, and those that successfully implement at least five recommendations can become designated "Choosing Wisely Canada Hospitals." 

The campaign recognizes that many drivers of overuse in hospital settings are often due to automation and outdated organizational policies and processes, including order sets, medical directives, lab order panels and computerized order entry systems, among others.  Choosing Wisely Canada Hospitals are those that constantly question current practices, and take action by implementing Choosing Wisely recommendations.

Less than a year in, a number Ontario hospitals  have taken up the challenge of becoming Choosing Wisely Canada Hospital. From Windsor Regional Hospital, to Cornwall Community Hospital and Georgian Bay General Hospital, the Choosing Wisely Canada designation has struck a chord with many community hospitals across the province. Headwaters Health Care Centre in Orangeville, for example, has decreased unnecessary creatine kinase testing by 800%. "Participating in Choosing Wisely was a natural progression of our quality improvement plans and programs," said Sandy Critchley​, Director of Quality Improvement, Planning and Performance at Headwaters. "The tools and evidence are scalable for organizations of any size and the results serve all stakeholders by reducing potential harm to patients, using resources judiciously, and aligning care to best-evidence".

Academic hospitals have also joined the campaign, including Sunnybrook Health Sciences Centre, The Hospital for Sick Children (SickKids) and Hôpital Montfort, who observed a 32% reduction in unnecessary INR tests after decoupling PT/INR and aPTT testing in the emergency department. And while it began as an Ontario initiative, other hospitals across Canada have also taken up the cause, including McGill University Health Centre and the Jewish General Hospital.

At a time when Ontario hospitals are being asked to improve patient care while finding efficiencies, ​Choosing Wisely is as relevant as ever. A number of hospitals across Canada have taken significant steps to eliminate unnecessary tests and treatments and in the process, have become Choosing Wisely Canada Hospitals. Find out how your hospital can be part of this movement.​

Upcoming Webinar: January 2020

On January 22nd, Choosing Wisely Canada and the OHA will host a webinar showcasing the achievements of several Choosing Wisely Canada Hospitals, as well as provide an opportunity for interested hospitals to learn more. The webinar will feature Sunnybrook Health Sciences Centre's President and CEO, Dr. Andy Smith and the hospital's Choosing Wisely Canada Lead, Dr. Adina Weinerman, as well as Cornwall Community Hospital's Chief of Staff, Dr. Lorne Scharf. Presenters will describe the actions they took, and discuss barriers and opportunities they encountered. Participants should come ready with questions that will help them further their own local Choosing Wisely efforts.

Choosing Wisely Canada’s National Meeting: Call for Abstracts

There’s a fine line between what is necessary and unnecessary in health care. The Unnecessary Conference, taking place from May 25-26 at the Shaw Centre in Ottawa, will explore the nuanced ways in which overuse permeates health care delivery and what people are doing about it. The conference is hosted by Choosing Wisely Canada, in collaboration with the Canadian Medical Association.

Organizations are encouraged to showcase their Choosing Wisely Canada initiatives and innovative approaches in one of the interactive breakout sessions! Submit an abstract by January 31, 2020 to be considered. Topics will include medical education, measurement and evaluation, quality improvement, and patient engagement. 

For more information, click here.